Michael W Clancy, LCPC, LCADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LC1210 Issued in MD

Practice address

10630 Little Patuxent Pkwy
Suite 209
Columbia, MD 21044-3273

Phone

(410) 740-8066

Fax

(410) 740-8068

NPI assigned

Jun 23, 2006

Last updated

Jun 17, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1346276292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 LITTLE PATUXENT PKWY",
            "address_2": "SUITE 209",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443264",
            "telephone_number": "410-740-8066",
            "fax_number": "410-740-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 LITTLE PATUXENT PKWY",
            "address_2": "SUITE 209",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443273",
            "telephone_number": "410-740-8066",
            "fax_number": "410-740-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "LCPC, LCADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA323",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC1210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST RENDERING",
            "identifier": "647213-01",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NATL CAP REGION",
            "identifier": "M3280007",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilyn Cimonetti, LCPC
• Jennifer Ciotola, RN, BSN
• Cynthia Diane Cisneros, L.C.P.C.
• Marcia Claiborne
• Dorothy Jean Clancy, M.S., C.N.S.
• Ferris Clare, LPCA
• Clark J. Hudak, Jr.
• Cindy Louise Clark-Pizzo, R.N.
• Barbara A Clark, R.N.
• Brandon Clark, CSC-AD

• Mental Health Counselor in Columbia, MD
• Providers in Columbia, MD by specialty
• Mental Health Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.